专题研究(Monographic Study)

纳米刀消融术治疗局部晚期不可切除胰腺癌安全性及疗效评价

Published at: 2016年第25卷第9期

刘少朋 1 , 李晓勇 1 , 程冰冰 1
1 郑州大学第五附属医院 肝胆胰外科,河南 郑州 450052
通讯作者 晓勇 李 Email: lixy64@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.09.006
基金:

摘要

目的:评估纳米刀消融术治疗局部晚期不可切除胰腺癌的临床价值。方法:对2015年9月—2016年3月18例局部晚期不可手术切除胰腺癌患者行纳米刀消融术治疗,比较分析患者治疗前后临床资料。结果:所有患者手术均顺利完成,术中各项生命体征平稳。患者术后第1天血清淀粉酶浓度明显升高(P<0.05),随后逐渐降至正常水平;术后CA19-9水平呈逐渐降低趋势,且各时间点均低于术前水平(均P<0.05);心肌酶指标手术前后无明显改变(均P>0.05)。术后3个月内发生胰腺炎2例(11%)、低血糖、高血糖、胃排空障碍各1例(5%),对症治疗后均较快恢复,无胰瘘、出血、胆瘘等治疗相关并发症发生。患者术后生活质量评分及KPS评分均较治疗前明显改善(均P<0.05)。按EORTC标准,术后完全代谢缓解2例(11%),部分代谢缓解10例(55%),代谢无变化3例(17%),代谢恶化3例(17%),客观有效率为67%,疾病控制率为83%。结论:纳米刀消融术治疗局部晚期不可切除胰腺癌安全性高,疗效显著,应用前景广泛。


Safety and efficacy of nanoknife ablation for locally advanced unresectable pancreatic cancer

Abstract

Objective: To evaluate the clinical value of nanoknife ablation in treatment of locally advanced unresecable pancreatic cancer. Methods: From September 2015 to March 2016, 18 patients with locally advanced unresectable pancreatic carcinoma received nanoknife ablation treatment. The clinical variables of the patients before and after treatment were comparatively analyzed. Results: All patients underwent successful operation, and all vital signs were stable throughout the procedures. The serum amylase concentration of the patients was significantly increased on postoperative day 1 (P<0.05), but then, it gradually decreased to the normal level; the CA19-9 level of the patients presented a slowly decreasing trend after operation, which was significantly lower than that of preoperative value at each studied postoperative time point (all P<0.05); the myocardial enzyme indexes showed no significant difference before and after operation (all P>0.05). Within postoperative 3 months, pancreatitis occurred in 2 cases (11%), and hypoglycemia, hyperglycemia and gastric emptying dysfunction occurred in one case each (5%), which were all quickly relieved after symptomatic treatment, while no treatment-related complications such as pancreatic leakage, hemorrhage, and bile leakage occurred. The scores for quality of life and Karnofsky of the patients were significantly increased after operation compared with preoperative values (all P<0.05). According to the EORTC criteria, complete metabolic remission was achieved in 2 cases (11%), partial metabolic response was obtained in 10 cases (55%), stable metabolic disease was seen in 3 cases (17%), and progressive metabolic disease was found in 3 cases (17%), and the objective response rate was 67% and disease control rate was 83%, respectively. Conclusion: Nanoknife ablation has high safety and demonstrable efficacy in treatment of locally advanced unresecable pancreatic cancer, and it may have a great application potential.


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引用

引用本文: 少朋 刘, 晓勇 李, 冰冰 程. 纳米刀消融术治疗局部晚期不可切除胰腺癌安全性及疗效评价 [J]. 中国普通外科杂志, 2016, 25(9): 1259-1265.
Cite this article as: LIU Shaopeng, LI Xiaoyong, CHENG Bingbing . Safety and efficacy of nanoknife ablation for locally advanced unresectable pancreatic cancer [J]. Chin J Gen Surg, 2016, 25(9): 1259-1265.